Vision Plan
The EyeMed Select Vision Plan provides significant benefits and cost savings for routine eye exams, as well as a complete pair of eyeglasses (or contact lenses, instead of standard lenses).
You can receive care from an EyeMed in-network eye care professional or an out-of-network provider. If you choose an out-of-network provider, you will generally pay more and you will be responsible for paying the provider directly, as well as submitting a claim for reimbursement.
Vision Benefit Summary
Benefits may be subject to certain restrictions and limitations. Be sure to refer to the Plan Documents for a more complete description of plan benefits.
| Benefits | EyeMed Select Vision Plan |
|---|---|
| Eye Exam In-Network Out-of-Network | $10 copay Up to $50 reimbursement |
| Frames/Lens | |
| Single Vision In-Network Out-of-Network | $15 copay Up to $42 reimbursement |
| Bifocal Lenses In-Network Out-of-Network | $15 copay Up to $78 reimbursement |
| Trifocal Lenses In-Network Out-of-Network | $15 copay Up to $130 reimbursement |
| Frames/Lens | $130 allowance plus 20% off balance over $130 Up to $74 reimbursement |
| Contacts (in lieu of glasses) | |
| In-Network Medically Necessary Elective | Covered in full $130 allowance plus 15% off balance over $130 |
| Out-of-Network Medically Necessary Elective | $200 allowance Up to $104 reimbursement |
| Exam Frequency | 12 months |
| Lens Frequency | 12 months |
| Frames Frequency | 24 months |
| Network Website www.eyemed.com | EyeMed Select |
Find a Provider
To find an EyeMed network provider or to request an out-of-network reimbursement claim form, log on to www.eyemed.com or call 866-299-1358.
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